The following invention relates generally to a method and apparatus for transferring fluid from a deformable ampule or vial into a syringe, injecting system (IS) or cannula without the need for a needle. More specifically, a male and female docking arrangement is disclosed coupled with structure for storing and transferring liquids so that the number of times needles are used in a medicating situation is kept to a minimum. The ampule has a structure which docks with the syringe, (IS) or cannula in a fluid tight sealing arrangement and the ampule is designed to collapse easily when extracting a substance such as liquid therefrom so as to preserve the fluid tight seal and therefor not allow air into the ampule, or syringe, or injecting system during the collapsing phase.
Diseases such as nosocomial infections, hepatitis and AIDS, which are pathogens that can be transmitted with the body fluids of a person, are running rampant globally. As a result, medical environments such as hospitals spend considerable amounts of money, time and energy attending to the problems that arise when hypodermic needles are required.
Complex protocols are evolving which attempt to minimize the likelihood of a needle stick from the time that a needle has been removed from its sterile storage environment through loading, utilization and disposal. Examples of heightened care with respect to the use of hypodermic needles are chronicled in patent literature, in the development of anti-stick needle caps, devices which destroy the needle itself after use and other instrumentalities for receiving both the used needle and syringe for safe disposal. Thus, the prevailing systems are based on the premise of the very existence of the needle for the medicating process.
The instant invention to a large extent obviates the need for the needles themselves in the many common instances where syringe needles have heretofore been used. Typically, one scenario where the use of a hypodermic needle is now commonplace includes the steps immediately prior to injection in the patient. The process involves loading the syringe with a sterile, pharmaceutical-grade fluid by extracting medicating fluid from a vial by using the affixed needle of a syringe for access. When using an ampule, the tip is broken off and then the ampule is entered with a needle, often a filtered needle to filter out glass particles. Next, the patient who is to receive this medicating fluid is injected with a new needle.
Prior art drug containing vials are formed from an open mouthed bottle or jar wherein the walls of the container defining the vial are rigid and non-flexible. The opening of the jar includes a lip which supports a metal ferrule which supports an elastomeric diaphragm made from a rubber-type material having a resealable property such that once the diaphragm has been penetrated by a needle and then removed, the diaphragm reseals itself. Typically, a syringe body is first fitted with a hypodermic needle. It is common practice that prior to the needle being plunged into the vial through the rubber diaphragm, it is first loaded with ambient air. Because the prior art vials are rigid, the vial is first pressurized to assist in fluid withdrawal. While this technique makes it easier to withdraw fluid, it introduces non-sterile air into the vial. Technically, the needle is to then be replaced with a new needle prior to injecting a patient.
The syringe is, in general, an elongate cylindrical object having a plunger adapted to reciprocate within an interior hollow. By withdrawing the plunger from the interior of the cylindrical hollow, fluid is drawn from the vial and is loaded into the syringe. Once the syringe has been removed from the vial, great care must be exercised for a multiplicity of reasons. The medication contained within the syringe is now provided with the present ability to discharge the medication to any who come in contact with the needle, albeit inadvertently. In order to reduce the amount of time a xe2x80x9cloadedxe2x80x9d syringe is carried, the medicating healthcare professionals normally will use a cart which contains all pharmaceuticals which are to be distributed during rounds to the patients. This reduces the amount of time the healthcare professional is required to walk with an armed syringe whose needle has been exposed or whose exposed needle has been recapped. Recapping provides further risk of self sticking due to misaligning a needle cap with the syringe.
After dispensing the medicine to the patient, the healthcare professional typically has one of several choices, none of which is entirely satisfactory for safe disposal of the needle. In one scenario, the healthcare professional is required to carefully recap the needle hoping that in the multiple times this procedure is reperformed he or she does not misalign the cap with the needle and inadvertently suffer a needle stick.
Another device has been developed which appears like a pencil sharpener and allows the healthcare professional to place the leading end of the syringe into an opening where an electric current is applied to the needle which melts the needle.
A third strategy involves discarding the needle and the syringe in a container for subsequent destruction or internment as biomedical waste. This technique presents ongoing risk to people who subsequently handle this waste.
The Food and Drug Administration (FDA) has accordingly issued an alert urging hospitals to use needleless systems or recessed needle systems instead of hypodermic needles for accessing intravenous lines. Plastic cannulas now exist which can fit onto luer connections and penetrate sealable diaphragms on infusion catheters. Thus, the FDA is urging the use of hypodermic needles only to penetrate the skin.
The following prior art reflects the state of the art of which applicant is aware and is included herewith to discharge applicant""s acknowledged duty to disclose relevant prior art. It is stipulated, however, that none of these references teach singly nor render obvious when considered in any conceivable combination the nexus of the instant invention as disclosed in greater detail hereinafter and as particularly claimed.
Evers (see for example FIG. 3 or 6) only connects with a syringe because its xe2x80x9ccontainer (1) is provided with an outlet opening (2) having a surface in the form of an outwardly widening truncated conexe2x80x9d (see column 2, lines 27-29).
When the Evers device is installed on a syringe tip the vial (1) must first be axially advanced to the right of the Evers right-hand side drawing. This causes a radial force by distending the outwardly widening truncated cone (2). Once the axial force is no longer applied, there is still a tendency or a reaction of the plastic material forming the outwardly widening truncating cone (2) to return to its original unstressed configuration. Since the cone is acting on a surface which is canted with respect to the long axis of the vial, the surface has a force component parallel thereto which encourages the vial to slide off from the syringe. Evers featured a second embodiment (FIG. 6) wherein the opening xe2x80x9chas been provided with peripherally arranged interior annular grooves across the outlet direction. Grooves of this kind apparently give improved sealing for the syringe tip (8) especially if the outlet opening is made of very thin and flexible plastic material.xe2x80x9d (Column 3, lines 4-8.)
Kimber, et al. provides a neck portion (3) (FIGS. 2 and 5), but this is not the area of frangibility. Fracture occurs above the neck portion at outlet opening (7) and threads are located in the area between the opening (7) and the neck portion (3). These threads are intended to coact with the internal threads (15) carried on the peripheral wall (12) of a conventional luer coupling on the syringe. The threads are advanced until they bottom out against a bottom wall (13) on the luer coupling.
Holtz teaches the use of a cap interposed between the syringe and the vial. Holtz, column 3, lines 32, et seq. states xe2x80x9csince the cap (5) makes the assembled bottle and adapter (1) completely sealed and caps (12) and (14) make the syringe completely sealed these two assemblies may be carried loose . . . with no fear of contamination . . . xe2x80x9d. Thus, the cap (5) and adapter (1) remain with the vial while the caps (12) and (14) remain with the syringe.
Stegmaier teaches the use of a cap tailored to never be reinstalled so as to prevent the bottle from being refilled. Thus, the portion that has indicia thereon includes a frangible section which precludes and xe2x80x9cobviates the likelihood of refillingxe2x80x9d (column 1, lines 10-11). Thus, once the cap has been removed from the bottle, it is never possible to be reattached. Thus, any indicia on the cap has limited value because it cannot be reassociated with the syringe that contains the contents heretofore in the vial.
Hansen teaches a vial constructed to more easily remove the tab, allowing access to the vial""s interior.
This invention chronicles further efforts by the applicant enhancing U.S. Pat. No. 5,716,346.
By way of contrast, applicant""s invention differs markedly from the foregoing. The vial 10 includes a tapering section 8 which converges to an opening 12. When this convergent end (and its circular profile) runs over the cone shaped luer end of the syringe, it is distorted and distended. As it approaches an annular outer wall of the luer coupling it wedges between the annular wall and the cone of the syringe tip. The vial collapses during emptying, assuring no ambient air contamination.
The instant invention completely avoids the use of a needle when extracting fluid from a vial or ampule. In its essence, the instant invention takes advantage of a coupling that is the standard on a majority of syringes which had heretofore only been used in the past to support the hypodermic needle on the syringe. This coupling, called a luer fitting, has a male component and a female component. Typically, the syringe is configured with the xe2x80x9cmalexe2x80x9d luer coupling which appears as a truncated cone that has an opening at its narrowest cross section. The luer coupling diverges toward an interior cylindrical hollow portion of the syringe. The instant invention replaces the xe2x80x9cfemalexe2x80x9d luer coupling and associated needle itself and instead replicates the female coupling on a specially formed ampule or vial so that docking between the ampule and a needleless syringe benefits from the pre-existing male coupling already found on common syringes. Walls of the ampule or vial are flexible to promote removal of the fluid therewithin.
The walls of the ampule are further tailored to promulgate collapse in a preordained manner. This collapse occurs by forming the ampule with a shape that provides a force gradient along the outer skin of the ampule when liquid is extracted beyond the fluid tight connection with the syringe.
With an opening of the ampule and the opening of the syringe in face-to-face docking registry and in fluidic communication, the ampule can be evacuated by any of a combination of manipulative steps. First, assume the syringe is in its initialized state, with its plunger nested well within the cylindrical hollow of the syringe body so that the plunger is in a compact, retracted state. The contents of the ampule can then be transferred with a negligible amount of air bleed at the ampule/syringe interconnection by deforming the side walls of the ampule and xe2x80x9cmilkingxe2x80x9d (i.e. applying hydrostatic force to) the liquid through the ampule walls and thus into the syringe. This causes the plunger of the syringe to translate along the cylindrical hollow. As the plunger advances along the cylindrical hollow, liquid enters the syringe.
Another strategy involves manipulation of the plunger to draw the fluid from the ampule by suction so that the filling of the syringe occurs by retracting the plunger to extract the liquid from the ampule while collapsing the ampule. The ampule is specially constructed to collapse. As before, the plunger starts well within the syringe and reciprocates outwardly of the cylindrical hollow.
A third strategy is a hybrid of the two previously discussed techniques which involves manipulation of both the ampule by (1) squeezing the ampule and suction by (2) moving the plunger out of the syringe cylindrical hollow. Thereafter, the ampule may be disconnected from the syringe for syringe deployment.
Once the ampule has been removed, a syringe has the intended fluid medication disposed therewithin. Unlike the prior art, no needle has yet been involved. Also, no air from the ambient environment has been mixed with the sterile fluid as was the case with prior art rigid wall vials. The seal between the syringe and ampule, coupled with ampule wall deformation excludes ambient air.
In one form of the invention, it is contemplated that the opening associated with the ampule is provided with a removeable cap having a luer-type coupling and an indicia bearing tab. The volume and medicinal contents of the ampule is stamped on the tab for identification purposes. With such an arrangement, it is possible to transfer the cap and tab from the ampule and connect the cap to the syringe to provide a tell tale of the contents of the fluid contained within the syringe. As an alternative, the ampule could remain docked to the syringe until subsequent use. The ampule would also note its contents on a surface thereof.
As a result of this system, the entire process for filling a syringe has been accomplished without the use of a needle. Personnel are able to operate more quickly with less fear of either inadvertent needle stick or inadvertent exposure to the medicine contained within the syringe.
It is to be noted that for many in-patients, the standard procedure in a hospital is to tap into a person""s vein only once with an infusion catheter and to leave the catheter needle in place with tubing communicating therewith so that subsequent fluids such as intravenous drips and the like can be used. With such a system, a needle would never be needed with the syringe according to the present invention. xe2x80x9cYxe2x80x9d connectors are well known in the art, one branch of which would have a complemental female luer coupling. Thus, for a patient""s entire stay at a hospital, the only needle associated with that one patient, ideally, would be the one which initially had been placed in the patient""s vein to support the infusion catheter. In this way, the opportunity for inadvertent needle sticks would be reduced to an absolute minimum.
The instant invention is further distinguished over the known prior art in that zones of programmable deformation are strategically provided which encourage collapse of the body of the ampule with less pressure than has been heretofore experienced. By providing this important feature, it is possible to provide wall thickness which can be somewhat thicker while still affording the same ability of the walls of the ampule to collapse on itself. The interplay of the present invention is between the sealing forces that exist between the docking of the syringe and the ampule. This sealing force should be as high as possible while providing the thickest wall possible on the ampule and still allow easy collapse of the ampule. By having a relatively thicker wall, the ampule is more robust and provides a further impediment to transpiration through the wall of the ampule. An ancillary benefit is that the criticality of the wall thickness during blow, fill, seal (BFS) manufacture has been lessened.
Accordingly, it is a primary object of the present invention to provide a method and apparatus for transferring sterile fluid from an ampule to a hypodermic syringe without the need of a hypodermic needle.
It is a further object of the present invention to provide a device and method as characterized above which reduces the amount of time which hospital staff must spend in transferring fluid from a sterile ampule to a hypodermic syringe while also eliminating the fear of an inadvertent needle stick thereby avoiding the possibility of both unwanted contamination and unwanted medication.
A further object of the present invention contemplates providing a device and method as characterized above which is extremely inexpensive to fabricate, safe to use and lends itself to mass production techniques.
A further object of the present invention is to provide a device which can reduce the number of times that needles are required in a hospital or other medical setting.
A further object of the present invention contemplates providing a device and method which minimizes the disposal problems of hypodermic syringes with needles.
A further object of the present invention contemplates providing a device and method for use in which a telltale is associated with first the ampule that stores the medicine, and then the syringe so that the fluid transferred from the ampule and into the syringe will be known at all times. In this way, the chain of custody of the fluid can be more readily monitored.
A further object of the present invention contemplates providing a system for loading syringes that obviates the need for the medicating health professional from having to trundle a miniature pharmacy on a cart from patient to patient. By pre-filling the syringes at a remote location added security and efficiency may be provided.
A further object of the present invention is to provide a programmed ampule wall structure that promulgates collapse before the seal that exists between the ampule and the syringe or other fluid receiving device admits air therein.
When viewed from a first vantage point it is an object to provide a needleless dosage transfer system for removing a sterile fluid from a sealed vial to a conventional syringe. The syringe has a plunger such that the plunger of the syringe translates from a first position telescoped within an interior cylindrical hollow of the syringe to a second position where the plunger has been displaced from the interior hollow and replaced by the fluid. The vial is defined by an end, collapsible sidewalls extending from the end thereby defining a blind bore and having an open end, a coupler at the open end of the vial, and a removable cap occluding the open end at the coupler. The vial coupler is provided with means to connect to a needleless opening of the syringe to be in fluid communication therewith, whereby fluid can be transferred to the syringe from the vial without an interconnecting needle.
Viewed from a second vantage point, it is an object to provide a method for transferring injectable fluids from a storage ampule or vial to a needleless syringe or other injecting device using a male luer fitting or other fitting. The syringe has a first coupling and an opening which communicates within an interior cylindrical hollow of the syringe so that fluid passes by the first coupling through the opening and into the hollow to load the syringe. The steps include providing a vial filled with fluid and with an outlet which has a second coupler defining the outlet. The vial is sealed by occluding the coupler outlet with a cap Subsequently, removing the cap and orienting the first and second couplers into complemental fluid tight docking arrangement (so that the opening of the vial registers with the opening of the syringe) allows transfer of the contents of the vial to the syringe without the need for a traditional needle extraction system.
Viewed from a third vantage point, it is an object to provide a method for forming an ampule to transfer medicine to be injected. The steps include forming an ampule with resilient walls so that the ampule can be collapsed, forming an opening on the ampule such that the opening is circumscribed by a coupler which is fashioned to receive a dose administering device, filling the ampule with the medicine and finally capping the ampule opening.
Viewed from a fourth vantage point, it is an object of the present invention to provide an ampule having a body with means to promulgate the body""s collapse and a cap connected to the body and an opening at a scoreline between the body and the cap.
Viewed from a fifth vantage point, it is an object of the present invention to provide a method for transferring liquid from an ampule into a dosing device including the steps of: forming the ampule with the liquid by blow, fill and sealing; forming the ampule with a severable cap; and forming a body of the ampule with a zone of preprogrammed deformation to collapse upon liquid extraction.